Chronic hemodialysis (HD) has drastically reduced the acute mortality of end-stage renal disease (ESRD). Nevertheless, chronic renal failure patients undergoing HD still die at a markedly accelerated rate. This adverse outcome appears early, with death ensuing far faster than in age-matched control populations within a year of initiating dialysis, and the most frequent causes of death are cardiovascular events and acute infections1-3. Patients with chronic renal failure exhibit manifestations of diffuse tissue injury, chronic inflammation, loss of muscle mass and hypoalbuminemia, and severe malnutrition, and all have been strongly linked with adverse outcomes4-8. The pathogenesis mediating the connection between the aggregate of these underlying conditions and accelerated mortality is largely unknown. Thus, the search for novel biomarkers that can reliably identify those ESRD and/or HD patients at increased risk of early death, and especially those biomarkers that are linked to potential therapies, may have significant clinical impact in improving the outcomes of this otherwise unfortunate population.